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Health Care

Conservative forces are concerned that the National Institutes of Health have awarded $189,186 to Emory University to study transgender mortality (project information).

PUBLIC HEALTH RELEVANCE: The purpose of this study is to determine whether transgender persons defined as those who medically change the gender assigned to them at birth (male to female or female to male) have higher or lower risk of death and certain diseases than men and women that do not consider themselves transgender. Participants will be selected from medical records of two large health care systems - the Veterans Affairs Administration and the Kaiser Permanente. Transgender persons will also be asked to join focus group discussions and share their views about factors that may motivate or preclude their participation in research.

Members of the transgender community and health care providers caring for transgender individuals express concerns about mental and physical health problems in this population; however longitudinal studies of transgender populations in the US have not been conducted.

Last month I reported on the State Department's decision to ask its insurers to remove the transgender exclusion from its insurance plans and its largest insurer, the American Foreign Service Protective Association's decision to honor that request. The exclusion ends in January.

One of the most commonly voiced perceptions about transgender people is that because we are transgender we are of necessity also mentally deficient.

This is not a new belief.

When an individual fails to mature according to his (or her) proper biological and sexological status, such an individual is psychologically (mentall deficient). The psychological condition is in reality the disease.

When an individual who is unfavorably affected psychologically determines to live and appear as a member of the sex to which he or she does not belong, such an individual is what may be called a psychopathic transexual.

Laura Harrington is an employee of the University of Washington. Her twelve-year-old son is transgender. In 2008 she attended a conference to learn how to better raise her son, who first expressed his maleness at the age of 5. While there, she met the man who is now her husband, who is a transman.

Because of exclusions in both her health care policy and that of her employer, many of her husband's treatments are not covered.

There have been times when we've had to decide between paying the electric bill or paying for his hormone therapy. The electric bill has necessarily won out. As a result, he suffers bouts of depression, anger, frustration, stagnation, all of the logical outcomes for someone who isn't living the life they need to live.

--Laura Harrington, to state officials this past spring

Harrington and other advocates contacted the state Public Employees Benefits Board in April about the challenges transgender Washingtonians face.

Last week the benefits board began the process of discovering just how fast such coverage can be included in private and state-run insurance plans serving government employees and retirees. The goal is to require such plans to cover transgender services by January 2016...and to remove specific exclusions to hormone treatments and other care before that date.

This will require careful, thoughtful work on our part and due diligence to develop a comprehensive, evidence-based benefit ... that assures the highest quality of care to people with gender dysphoria.

Effective January 1, 2015 the city of Rochester, NY will cover medical services related to gender reassignment, including medical and psychological counseling, hormone therapy, and cosmetic and reconstructive surgeries, as announced by Mayor Lovely Warren at Empire State Pride Agenda's Spring Dinner on May 17.

The initiative is part of a plan steered by City Councilmember Matt Haag to raise the city's Municipal Equality Index.

Eliminating barriers to health care is simply the right thing to do. The city was the first to support domestic partnerships, and I am happy that we lead the effort to equalize benefits for all once again.

--Mayor Warren

The inclusion of transition-related care in municipal benefits will improve the health and well-being of transgender employees and also send a message to the rest of our state that we need to provide medically necessary care to all transgender New Yorkers. Rochester has long been a leader on LGBT civil rights and this is just one more example of how this great city sets a strong example for the rest of New York state.

Topic:

Dr. Norman Spack is a childhood endrocrinologist. He treats transgender kids. But 75% of his clents are located within 100 miles of his base at Boston's Children Hospital. Unfortunately, there are transgender kids all over the country who deserve equally good treatment.

Sr. Spack gave a TED Talk last autumn which has just recently been shared publicly (it was posted to the TED website on April 16). I've been saving this for the proverbial "rainy day" when I don't have time to write a column. And today I'm feeling the drizzle.

Spack talks about his efforts to treat those transgender kids in their journey through puberty.

Later the truth of the matter came out, when clinic staff told Taylor,

We don’t have to treat people like you.

When they said, ‘we don’t have to treat people like you,’ I felt like the smallest, most insignificant person in the world. The doctor and office provide hormone replacement therapy for others at the same clinic, they just refused to do that for me.

—Naya Taylor

The Affordable Care Act is partially a civil rights law in that it prohibits health care providers that receive federal funds from discriminating against any individual on the basis of sex for the purpose of health care.

Taylor is being represented by Lambda Legal in a lawsuit filed on Tuesday charging Dr. Lystila and the Carle health care services group which operates the clinic with denying medical care. Lambda Legal claims that discrimination based on sex extends to discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity, as per Title IX.